title: Examination of proposed DSM-5 changes to pathological gambling in a helpline sample.
abstract: OBJECTIVE
  To examine the effect of proposed the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5) changes to pathological gambling relative to DSM-IV criteria in a large gambling helpline sample (N = 2,750). Changes in prevalence rates, the diagnostic utility of the illegal acts criterion, and severity of alternative diagnostic formulation thresholds were examined.
  
  
  METHODS
  Callers to the helpline completed a semistructured interview and DSM-IV criteria were assessed.
  
  
  RESULTS
  Without lowering the diagnostic threshold, removal of the illegal acts criterion resulted in loss of diagnostic status in less than 2% of helpline callers. The DSM-IV prevalence rate in this sample was 81.2%, and DSM-5 formulations with lowered thresholds of 4, 3, and 2 symptoms increased prevalence rates by 9% to 17%. However, item-level symptom endorsement suggested that subclinical gamblers experience significant adverse consequences.
  
  
  CONCLUSIONS
  Lowered thresholds may lead to earlier provision of treatment to gamblers and prevent escalation of the disorder, while being more consistent with diagnostic thresholds of other addiction disorders.
authors.affiliation: Saint Louis University.
authors.forename: Jeremiah
authors.initials: J
authors.lastname: Weinstock
authors.forename: Carla
authors.initials: C
authors.lastname: Rash
authors.forename: Steve
authors.initials: S
authors.lastname: Burton
authors.forename: Sheila
authors.initials: S
authors.lastname: Moran
authors.forename: Warren
authors.initials: W
authors.lastname: Biller
authors.forename: Kathleen
authors.initials: K
authors.lastname: O'Neil
authors.forename: Norman
authors.initials: N
authors.lastname: Kruedelbach
mesh_terms: D000328:Adult; D000368:Aged; D001526:Behavioral Symptoms / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D005715:Gambling / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D019114:Remote Consultation / Q000706:statistics & numerical data; D012720:Severity of Illness Index; D013689:Telephone / Q000706:statistics & numerical data; D014903:West Virginia / Q000453:epidemiology; D055815:Young Adult
keywords: diagnostic criteria; gamblers; gambling disorder; helpline; pathological gambling; prevalence